As I’ve just given a 45-minute presentation to a workflow tech audience about healthcare and health IT opportunities, I thought, maybe now would be a good time to reflect on progress being made. By the way, I created the following YouTube from my slides and audio from that talk on 6/16.

While I’ve been giving presentations about workflow tech in healthcare literally for decades, I joined Twitter in December of 2008 (averaging 25 tweets a day) and starting blogging in earnest in 2009 (about a post a week). An important part of my strategy has been to blog and tweet about health IT to attract workflow tech community interest and followers. And to blog and tweet about workflow tech to attract health IT interest and followers. And, most important, get both communities engaged, on social media and face-to-face, with each other. Have I seen more sophisticated thinking about workflow and more use of workflow tech close-and-closer to the point-of-care? Yes, I have.

For example, each year I look at every web site of every exhibitor at the yearly HIMSS conference. Sites mentioning workflow tech or emphasizing workflow went from 8 percent in 2013 to 16 percent in 2014. Last week I was honored when John Lynn, without a doubt the top and most trafficked health IT blogger, contacted me about blogging once-a-day about workflow on his website, while he went on a well-deserved vacation. Check out the comments from both health IT and workflow tech professionals. Then there was the BPM and Case Management Global Summit early this week near Washington DC. (BPM stands for Business Process Management). When I started going to BPM and workflow conferences four years ago, there were no health IT folks at all. And the workflow tech folks were just beginning to get curious about opportunities to solve healthcare’s many workflow problems.

This year, there was intense conversation among a variety of health IT and workflow tech thought leaders. In addition, I’ve seen more-and-more healthcare workflow, BPM, and case management success stories. I tweet them whenever I find them. And I archive links to many at http://EHR.BZ.

I was delighted to see @TechyDoc there! I could not agree more wholeheartedly with his tweet!

@wareflo Huge opportunity for disruptive innovation in health care by BPM and Workflow industry. The iron is almost hot #BPMCM14

BPM and Case Management Global Summit Short Trip Report

Well, so far this post has been about counting healthcare workflow tech blessings. I’ve enjoyed it! But it’s back into the weeds, so to speak. The rest of this post focuses on presentations, conversations, and impressions from the recent BPM and Case Management Global Summit. Did I mention I spoke there? Oh, yeah. Please feel free to watch my slides paired with recorded narration, on YouTube. (There’s also this half-as-long outdoor rehearsal, in front of the Capitol dome, recorded with Google Glass, waving printed slides around on a windy day.)

This is what the conference venue looked like. (At a Ritz-Carlton, very nice!)

I like how the Whitestein Living Systems Process Suite elegantly combines high-goals, organizational roles, and workflow automation. So, let’s say a workflow is executing but assumptions or conditions change. Workflows can also change, on-the-fly, based on reasoning about goals. LSPS is not (yet) used in healthcare, but I can imagine a future EHR workflow system actually helping patients and physicians think through, for example, quantity vs quality of life constraints and tradeoffs.

Users can create tasks, execute them, and assign them to others. Task can also be automatically created, assigned, executed, etc., all the while consulting organizational models (which, in healthcare, could include physician, nurse, tech, and so on).

Love it! Integrated tasks management and execution easily integrated with existing systems. Users can easily change the rules that fire, execute, adaptive tasks. Workflows can be programmed, but also “emerge” from user behavior. All the while all these activities are time-stamped and made auditable.

Here’s an interesting diagram. In traditional workflow management and BPM systems models of workflow and their execution are at their core. In other words, users and data are adapted to fit to these models. Of course, these models can be changed in ways that software without executable models (such as most health IT systems) cannot. However, adaptive case management puts data, about, for example, patients, at the core, and then automatically, semi-automatically, and manually triggers snippets of workflow. Instead of big workflow models (rigid during execution, though plastic during design), workflow is actually driven, moment-by-moment, during the work of problems solving, by data at hand, both from previous transformation and newly arrived from the outside world.

Keith has a seven-pillar model framework to compare and contrast different kinds of workflow software. All the way on the left, that’s traditional software development. On one hand, anything is possible since everything is simply a matter of programming. On the other hand, workflow is also “frozen.” To change workflow requires an expensive programmer, who won’t get it right, and even if they do, there will be bugs, so there’s a long and expensive cycle of testing, deployment, and training.

All the way on the right is email, phone calls, Twitter, etc., in which anything goes, but the user has to do all the work too. In between? Those are five general classes of workflow tech, from relatively rigid process models to relatively flexible models that just try to support and empower users, without getting in the way.

I’ll note I think of the seven columns more as rows of layers. On the bottom we have traditional server-based programs. On top of that bottom layer we have process models, starting out rigid and infrequently changed, but, as we ascend the stack, more flexible but also require more work and smarts from users, until we get to the top layer of emails, phone calls, Twitter, etc. All of these layers exist together, interacting, building on each other, but also causing occasional glitches. A programmer might be deep in the bowels of a Java program, but in the next moment tweet snippet of code to his programmer followers.

The following tweet lists the folks at the BPM & Case Management Global Summit with whom I tweeted most frequently. If you’re interested in any of the same things I am, I hope you’ll consider following them on Twitter.

Ebola & EHR Workflow Engines, Editors & Visibility

Robot-In-My-Pocket

Charles Webster, MD, MSIE, MSIS

Bio: HIMSS14, HIMSS15, and HIMSS16 Social Media Ambassador! If you've got a healthcare workflow story, I want to tell it, blog it, tweet it, interview you, etc.
Chuck Webster, MD, MSIE, MSIS has degrees in Accountancy, Industrial Engineering, Intelligent Systems, and Medicine (from the University of Chicago). He's the ex-CMIO for a three-time HIMSS Davies Award-winning pediatric EHR. Dr. Webster currently services as CMIMO (Chief Medical Informatics Marketing Officer) for workflow technology in healthcare. Chuck also created Mr. RIMP (@MrRIMP) (Robot-In-My-Pocket) a Bluetooth-controlled wearable robot for pediatricians and child life specialists to entertain children. Dr. Webster designed the first undergraduate program in medical informatics, was a software architect in a hospital MIS department, and is a judge for the annual Workflow Management Coalition Awards for Excellence in BPM and Workflow and Awards for Case Management. Chuck is a ceaseless evangelist for process-aware technologies in healthcare, including workflow management systems, Business Process Management, and dynamic and adaptive case management. Dr. Webster tweets from @wareFLO, @HealthITdog, and @MrRIMP (though there is some debate about the last two). He maintains almost a half-a-million words and graphics on numerous websites, including EHR Workflow Management Systems (http://chuckwebster.com), Healthcare Business Process Management (http://HCBPM.com) and the People and Organizations improving Healthcare with Health Information Technology (http://EHRworkflow.com). Please join with Chuck to spread the message: Viva la workflow!